Features  |   March 2014
Ethical and Legal Implications of Special Relationships Among Health Care Providers
Article Information
Ethics / Medicolegal Issues / Features
Features   |   March 2014
Ethical and Legal Implications of Special Relationships Among Health Care Providers
ASA Monitor 03 2014, Vol.78, 20-22.
ASA Monitor 03 2014, Vol.78, 20-22.
Special relationships (romantic, spousal, partner or other intimate relationships) between health care providers have become more common with time. This article describes a hypothetical case (though based on a real case) involving a surgeon and anesthesiologist in which a complication that could have been caused by either one created a possible conflict of interest from both a medical and medico-legal standpoint. It then explores the medical, ethical, and legal implications of such cases and makes recommendations for minimizing the potential conflicts of interest due to special relationships between health care providers.
A 45-year-old man underwent an open inguinal hernia repair under general anesthesia supplemented by an iliohypogastric block for postoperative pain that was placed by an anesthesiologist. The patient’s surgeon and anesthesiologist were married to each other. The block, general anesthesia and surgery appeared to have gone uneventfully until the patient complained of abdominal pain postoperatively. An abdominal radiograph revealed free air of unclear origin. A subsequent exploratory laparotomy revealed a small bowel perforation near the site of both the nerve block and the surgery. Since the bowel could have been perforated by either the surgical dissection or the block needle, it was unclear whether the complication resulted from the anesthetic or the surgery. The case raised the question as to whether the married surgeon and anesthesiologist should have cared for the same patient, and also whether they had a real or potential conflict of interest with respect to the investigation since either of them may have caused the complication.
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